Jackie T. Chan, M.D., Inc.

LBN: Jackie T. Chan, M.D., Inc.
Jackie T. Chan, M.D., Inc. is an health care organization with primary practice located at 413 E Orangeburg Ave Ste A , Modesto CA 95350-5369. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Pain. Ambulatory Health Care Facilities / Medical Specialty is the primary health care specialty. Jackie T. Chan, M.D., Inc. can be contacted via phone (209) 543-8880, or through Chan, Jackie via phone (209) 529-4422.

Contact Information

Primary practice address
413 E Orangeburg Ave Ste A Modesto CA 95350-5369
Phone: (209) 543-8880
Fax: (209) 529-1711
Website:
Map and Directions
Authorized official contact:
Name: Chan, Jackie Doctor of Medicine (MD)
Phone: (209) 529-4422

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X G077865 California
Ambulatory Health Care Facilities / Pain 261QP3300X G077865 California

Profile Details

NPI number 1396954921
LBN Legal business name Jackie T. Chan, M.D., Inc.
DBA Doing business as
Authorized official Chan, Jackie Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2007
Last updated Aug 24th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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